Surgical patients nosocomial pneumonia

Most of the published studies report the incidence rate of nosocomial pneumonia, that is, the number of cases of nosocomial pneumonia per 100 hospitalized patients. In six studies summarized in Table 3, the incidence of ventilator-associated pneumonia ranged from 9% to 24% (20). These rates fail to adjust for the duration of ventilation and are therefore difficult to interpret. Device-associated incidence density rates of nosocomial pneumonia, that is, the number of cases of ventilator-associated pneumonia per 1000 ventilator-days, are reported only for three studies and range from 10 to 30 per 1000 ventilator-days (14,21). In the NNIS, rates of ventilator-associated pneumonia per 1000 ventilator-days range from 9.4 in medical ICUs to 14.9 in surgical ICUs, 16.9 in trauma ICUs and 20.9 in burn ICUs. 

The Smdy on the Efficacy of Nosocomial Infection Control (SENIC Project) published in 1981 demonstrated an association between surgery and nosocomial pneumonia (5). In this survey, pneumonias constituted 14% of all nosocomial infections detected among surgical patients, but 74% of all pneumonias occurred in surgical patients (40% of the total study population) (5). 

Mechanieally ventilated patients are exposed to multiple devices and are at particular risk of development of ventilator-associated pneumonia (VAP), the risk of which is proportional to the duration of assisted ventilation (see Table 4). The rates of nosocomial infections may be influenced by the type of intensive care unit in which the patient undergoes treatment, with higher rates observed in surgical intensive care than in medical ICU patients (22,129,130). We examine specific devices that have been associated with NP... 

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